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What are the Duties of the Board?

Rules, determine qualifications for licensees, issue licenses, procedures to ensure compliance with rules, improve standards for marriage and family therapists, improve standards of enforcement, code of ethics, CEU requirements.


What are the Requirements for licensure?

18 years, good moral character, citizen/lawful resident....


What is Privilege?

Communication during therapy is privileged unless:
Disclosure is required by other laws.
Failure to disclose presents clear and present danger.
Person/therapist is defendant in criminal case re: therapy.
Patient is defendant in criminal case and privilege would violate their right to due process, present testimony and witnesses on their behalf.
Patient waives privilege (including all clients present during family/couple therapy).


What is considered sexual contact?

With consent or without: vaginal, anal, oral sex; any intrusion into genital or anal openings by any body part or object (patient or therapist); kissing; intentional touching of genitals, groin, inner thigh, buttocks, breast directly or through clothing by therapist/patient; requests by therapist for any of the above.


When is there a cause of action for sexual exploitation?

Sexual contact occurred during period of therapy; after period of therapy and patient was emotionally dependent on therapist or occurred by means of therapeutic deception.
Rule 5300 also states no sexual contact within 2 years of therapy.


When can you release or disclose health records?

Patient provides written consent; specific authorization in law (such as board investigation, duty to warn).

Exceptions to consent:
Medical emergency and unable to obtain consent.
For other providers in related health care entity when necessary for current treatment.
Client is involved in emergency interaction with law enforcement and disclosure is necessary to protect client or another.
MUST document any disclosure without consent!

In 5300 rules: To protect against clear and substantial risk of imminent serious harm - may disclose to law enforcement, potential victim, family of client, or others in position to prevent/avert harm.

Generally, consent expires after one year if not otherwise specified.
Copies of health record.
Pertinent portion of record relating to condition specified by patient.


When can you withhold records from a patient?

It's detrimental to client, may provide to third party instead.
Prior to request for records, provider states in writing specific reason for withholding information.


When can a minor give effective consent?

Living independently and managing own finances.
Borne a child.
Emergency situation.
Contraceptive care or abortion.
Seeking treatment for pregnancy or associate conditions.
Seeking treatment related to STD and/or alcohol/drugs.
16 or older can seek inpatient treatment


What is the mature minor doctrine?

Can treat minor if:
No other exceptions to parental consent AND parental involvement is impractical/problematic.
15 years old
Able to give informed consent
Proposed treatment is for minor's benefit
Proposed treatment is deemed necessary
Proposed treatment is not complex or high-risk.


When can a minor be involuntary admitted to a facility?

"Transportation hold" - by peace officer or health officer and minor is mentally ill, chemically dependent and in immediate danger of injury to self or others.

72-hour emergency hold - consent of head of facility, examination is last 15 days, mentally ill/chemically dependent and in immediate danger of harm to self or others, and court order cannot be obtained in time.

More than 72 hours, need a petition for commitment.


What is the difference between sexual abuse and sexual assault?

Mandated to report sexual abuse (or sexual contact as a result of caregiver neglect).
Abuse - offender is responsible for care, in position of authority, has significant relationship (related, resides in same dwelling) to minor.
Assault - offender is stranger or not one of the above.


Are you mandated to report criminal sexual conduct?

No, unless offender is responsible for minor's care, offender has significant relationship to minor, offender in position of authority over minor, or action was result of caregiver neglect.


Are you mandated to report prenatal exposure to THC or alcohol?

No. Health care professionals and social service professionals are exempt from reporting only THC use and alcohol use if providing prenatal care or other health care services
If another controlled substance for nonmedical purposes, YES.


Who is a vulnerable adult?

“Vulnerable adult” – physical or mental disability or dependency on institutional services.
Possesses dysfunction that impairs ability to care for self and impairs ability to protect self from maltreatment


What is physical abuse?

Any physical injury, mental injury, threatened injury inflicted by person responsible for child's care. Any aversive deprivation. Not an accident. Cannot be reasonably explained by history of injuries. Does NOT include reasonable and moderate physical discipline not resulting in injury.
E.g. Throwing, kicking, burning, biting, cutting, striking with closed fist, shaking child under 3 yo, striking under 18 mos resulting in injury, unreasonable interference with breathing, threatening with weapon, etc.


What are you mandated to report?

Neglect, physical abuse, sexual abuse of child.
Neglect, abuse, maltreatment of vulnerable adult.


What is sexual abuse?

Person responsible for care or who has a significant relationship subjects child to criminal sexual conduct, violation of prostitution offenses, trafficking, threats of sexual abuse.


What is substantial child endangerment?

Person responsible for care, by act or omission, commits:
Egregious harm
Abuse, physical and sexual


How do you make a report?

Within 24 hours, call the responsible agency and make a report. Include child's name, age, contact info, details known of alleged incident, alleged perpetrator's name, contact info, my name and contact info. Follow up with written report within 72 hours. Does not include weekends and holidays.


What is significant impairment in functioning?

Condition, including significant suicidal ideation or thoughts of harming self/others, which harmfully affects a person's activities of daily living in work, housing, family/social relationships, or education.


What is mental illness?

Organic disorder of brain; clinically significant disorder of thought, mood, perception, orientation, memory, or bhvr in the DSM/ICD-10 that seriously limits capacity in daily functioning.


What is SPMI?

2+ inpatient care for mental illness in last 24 mos; continuous psych hospitalization/residential treatment more than 6 mos within last 12 mos; treated by crisis team 2+ times in last 24 mos.


What are patient's rights?

In addition to patient's bill of rights!
Access to their information re: diagnosis, treatment, prognosis.
Written notice re: access to health records and disclosures of health records.


What is reciprocity?

Holds license from another jurisdiction and standards are at least equivalent.
If licensed continuously as LMFT in US for 5 yrs preceding and no adverse actions taken, education and postgrad requirements are considered satisfied.
If licensed for less than 5 years, will determine if requirements satisfied.
If did not pass natl exam, must pass it.
Everyone must take state exam.
Everyone must apply to board and pay fee.
Everyone must agree to abide by code of ethics.


Failure to renew license

License expires if no renewal within 30 days of expiration. No longer authorized to practice.
May voluntarily terminate license any time upon written request, unless complaint pending.


Reinstating license

No circumstance to justify revocation/suspension
Has not engaged in practice since expiration
Completed reinstatement application
Reinstatement fee
Reasons for applying for reinstatement

Expiration of less than 5 years:
- Evidence of meeting CEU requirements that would have applied
- Pay renewal fee of each term license was expired

Expiration of more than 5 years:
- Meet current education and education requirements for licensure
- Retake and pass national and state exams
- Evidence of 5+ years of CEUs
- Pay renewal fee for each of five years preceding application


What is emeritus status?

Age of 62 yo
Apply to board
Not subject to current disciplinary action
Pay onetime emeritus fee
May not practice as MFT or MHP
If want to reinstate, follow aforementioned procedures


What do you need to know regarding teletherapy?

Client must be resident of state in which you are licensed.
Must follow jurisdictional rules of my location and client's location.
Must go over informed consent re: risks/benefits of teletherapy.
Must use HIPAA compliant software.


Patient's bill of rights

1. Therapist is qualified
2. Examine public records re: therapist's qualifications
3. Report complaints to board
4. Informed of cost before services begin
5. Privacy as defined by rule and law
6. Free from discrimination
7. Access to their records
8. Free from exploitation


What do you do if you receive a subpoena?

Let client know right away
Ask client how they'd like to proceed
If it's ok to provide info, get written consent for release
If not, let subpoena party know cannot provide info without client's consent and need order from a judge.